PARASITE A.K.A. EGG ADULT INFECTIVE DIAGNOSTIC HOST LOC.INT
HOST2NDINTHOST PATHOLOGY MOT PHIL Tx
Trichuris trichiura
Whipworm
Barrel-S, 2 plugsunembryo
M – curved 360F – blunt; stichocytes
Embryonated Egg in soil/feces
embryonated in soil
DFS Unembryo eggs in feces
LI, Whipinserted into wall
no migrationphase to lungs
-Prolapse of Anus-IDA, Alb, D-Sometimesappendicitis-symptoms due to unique mode of attachment
F-O-R(fecal-oral route)
Yup
80-90%
warm,tropicalregions
Albendazole
Mebendazole
Oxantel-Pyrantel
EnterobiusVermicularis
SeatWorm
Pinworm D-shape,
football
spindle-S, cephalic ala,corpus, isthmus, bulbM – curved tailF – pointd tail
Embryonated ova Scotch tapeSwab
EmbryonatedEggs
Ileum of SI, Cecum,LI man
Gravid femaleMigrates to Perianal area
1) site - ulceration2) eggs - prupritus3) migration-vulvuvag & salphingitis
H-M(hand-mouth)
inhalation
Retroinfection
Yup (F>M)
Mebendazole
Pyrantel pamoate
TrichinellaSpiralis
larva – w/ spearlikeburrowing tip
thread-like ; F – blunt;M – curved w/ 2 lobular appendages;A-end- non-papillated
Encysted larvae inInad cooked pork
Tissue biopsy
Xenodiagnosis
Bachman Intradermal test
Muscle tissue of man, pigs
-Rheumatic pain(intestinal flu)- M eosin-swollen eyelids-3 stages of inf:intest,larval,encap-Stage of conval- death due to Myocard or enceph
Ingestion of encystedlarvae inpork
yup Thiabendazole
Corticosteroid(for allergic rxn)
Mebendazole?
Ref (5F 20d, 20F10d, 20F 6d)
CapillariaPhilippinensis
peanut shapeembryonated eggs in Ftypical F – 8 in 1 rowatypical F – 40 in 2M – w/ chitin spicule
Larva in raw fish
Eggs embryonate inFresh water
DFS-eggs (E)-larva (L)-adults (A)
SI (jejunum ) of fish, man
larvae in gastric mucosaand intestines
-int mal-ab-Borborygmi-Ab Pain-Diarrhea-Villus flat-Atrophy COL-death
Ingestion Of larvaIn raw fish
Yup (M>F)I. Norte(N.Luzon)
THA,JPN,EGY,TAI,IRAN
Mebendazole
Albendazole
AscarisLumbricoides
Most commonIntestinalnematode
GiantRoundWorm
Decorticated,Unembryo egg
tri-radiate xsF-3 lips; M–2 spicules
Embryonated Egg
larvae, corticated
DFS of eggs
Adults in SIGall bladder,Liver, nares,appendix
SI of man(not attach)
Liver-lung Migration(larv swallowed)
Lung mig –Asthma;Capil penetration–Pneumonia; Ab Pain due to adultMigration; Int Obst; eosin
Ingestion
Burrowing ofSin of foot
Yup
MostCommonIn world
PeperazineCitrate
AlbendazoleMebendzaolePyrantel Pam
AncyclostomaDuodenale
OldWorldHookworm
teeth 3rd stage filariform DFSEIA
-ELA
SI
Lung migration
Ground itch; <500 eggs in feces = light worm,
Oralpercutaneous
Yes
Tropics,subT
PyrantelPamoate
Mebendazol
8-cell stagepointed tail, short esophagus
>500 eggs = heavy worm; Hookworm anemia due to suction of blood/ bleeding
Microcytic Hypochromic
e
Iron replacement
NecatorAmericanus
NewWorldHookworm
cuttingplates
DFSEIA
-ELA
SkinPenetration
StrongyloidesStercoralis
ThreadWorm filariform;
no F MLong eso,Prominent Genital primordium, notched tail
3rd stage filariform Rhab in stool
short buc cav
SI man; Lung Migr aftr skin Penet; reproparthogenesis
Eggs hatch SI
Larval migration – Lobular pneu w/ hem;like PUD, Hyper Infection, Peripheral Eosinophilia, malabsyndrome
- SkinPenetrationof FL- Free-living- autoinfection
Yes
Tropics,SubT
Albendazole
Thiabendazole
PARASITE A.K.A. EGG
ADULT INFECTIVE DIAGNOSTIC HOST LOC. INT HOST2ND
INTHOST
PATHOLOGY MOT PHIL Tx
Brugia Malayi kinky, overlapping nuclei, nuclei reach tail end (terminal, subterminal n.)
giemsa – sheath unstained
Larvae InArthropodVector
Bites at Night
EntersBitewound
Bioincub- 1 year
Blood smear(thickAnd KnottConc)
MicrofilariaIn blood atNight
CARD Test –Antigen det
DNA probes
LymphaticsBloodstream
Peripheral Blood
mosquitos
W.B. –Culex QuinqueFasciatus
Rural-Anoph;Urban-Fatigans;Pacific-aedes
Acute – Hypersensitizatn
Chronic – (poor prog),elephantiasis(blocks lymphs)
Weingarten’sSyndrome –Hyper-eosin ofPeripheral blood
Skin
Larva Enter bitewound
MosquitoBites atnight
Yup
Warm regions
Diethylcarbamazine(not effective onadult worms)
Ivermectin
corticosteroids
supportive – pressure bandaging
surgery
WuchereriaBancrofti
smooth, single row of nuclei, no term nuc,>L than BMgiemsa –
pink stainLoa Loa
shedding of sheath,
Larvae crawl intowound
Thin bloodSmear
biopsy
Subcutaneoustissue
Vector- Dipteran(chrysops)
Calabar swelling
Adult in eye
hypersensitivity
Skin
Larva Enter bitewound
No
Africa
Diethylcarbamazine
Corticosteroids
surgery
DracunculusMedinensis
FierySerpentIsraelites
Guineaworm
larva migrates to lower ext.
Larvae incopepods
Local lesionWorm/Larvae
Calcifiqed Worms byx-ray
Mesenteric Tissues
Larva migrateTo lower ext
CopepodsIngestLarva in water
Blister w/ Serous exudates
Pseudoperitonealsyndromes
IngestionOf Infectivecopepods
NO
MiddleEast,Africa
Metronidazole
Thiabendazole
OncocercaVolvulus
Larvae Crawl intoBite wound
Biopsy
Mazzotti
Slit lamp
Subcutaneoustissue
Vector-Black fly
-River Blindness-Eye lesions- Skin lesions- Scrotum enlargement
Skin
Larva Enter bitewound
NO
AfricaC. and S.America
Diethylcarbamazine
Corticosteriods
Surgery
AngiostrongylusCantonensis
RatLungworm
adult emale “Barber pole” dark red intestinal tract
3rd stage larva in snailsand slugs or rats ingestedby man
snails – paratenichosts
History-eating, travel
leukocytosis& eosinophilia
Skin test needsevaluation
Brain
Spinal cord
Man- Accidentalhosts
Mollusks,Snails:Achantina,Pila
Planaria,Slugs,prawns
Eosinophilic Meningoencephalitis
+ eosins in CSF,CN involve, diplopiaand strabismusCSF >= 500 cells/ml w/ 10-90% eosins
IngestionOf larvaIn snails
NO
TAI, THAI,CAM, VIET,Hawaii, Tahiti
None recommended
Dead parasiteCould exacerbateTissue reaction
Surgical if ncessary
Angiostrongyluscostaricensis
3rd stage larva in snails/ slugsingested by man nd cotton rat (Sigmodon hispidus)
Intestines(gut wall)
Mollusks
Snails,slugs
“acute abdomen”- inflamm of ileocecal region; Ab pain loc toright lower quad +palpable tumor-like m
Anisakis Herringdisease
Terranova sp – juveniles
Pseudoterranova sp – not penetrate
Eustrongylides sp – perforates largebowel
3rd stage larvain flesh of rawfish; larva migrate from viscera to muscle after death of fish
Edoscopy
ImmunologicTests underStudy
MarineCrustaceansAnd fish
Pseudoterranova spp –Not penetr8 stom, Throat irrit, coughed
IngestionOf rawMarine Food w/Alcohol,“green”herring,sashimi
NO
JPN,Netherlands
Remove larvaeBy biopsyForceps
Surgical InterventionFor obstruction
Manage conservatively
Anisakis simplex (USA)Stom, int, inflammRxn surrounding larvaAnisakiasis – localTissue response;(Eustrongylides spp)Perforation of L bowel
PARASITE A.K.A. EGG ADULT INFECTIVE DIAGNOSTIC HOST LOC. INT HOST2ND INTHOST PATHOLOGY MOT PHIL Tx
SchistosomaHematobium
Platy-helminthes
terminal spine
S. Japonicum
in copula, males have gynecophoric canals
Free-swimmingCercaria
Eggs, miracidiain urine
Adults - Bladder,liverlarva – Venous Plexuses
Bulinus Snail(Miracidia tocercaria)
Calcified Bladder (dead eggs= “sandy patches”); Painful urination;Kala-azar; adults coated w/ RBC An
and not detected; trappedegg cause clinical symptoms;Terminal Hematuria; infection
linkedTo S. typhi and paratyphi carriers
Skin PenetrationThruInfectedwater
WalaSiguro…
Tropics Subtropics
Praziquantrel
SchistosomaMansoni
Platy-helminthes
lateral spine
Free-swimmingCercaria
Ova in feces (blood,mucus)Rectal biopsy
Liver
Mesentericvenules, SC, lungs
BiomphalariaSnail
Claypipe-stem Fibrosis =Thickening of portal vessels due torxn w/ eggs; Hepatosplenomegaly
Portal HTN, ascites, eggs sometimes
Deposited in SC, lungs liver enzy,serum alb, glob(prot)
Cercaria PenetrateSkin thruInfectedwater
Nope
AfricaBrazil
Praziquantrel
SchistosomaJaponicum
Platy-helminthes lateral knob
Cercaria Ova in feces,Rectal biopsy,COPT test,
Liver,MesentericVenules,SI, heart,Spleen, Oncomelania
Quadrasi,
Katayama rxn/ fever, reaction toEggs in tissue = CNS damage,
Hepatosplenomegaly, Portal HTN,Ascites; mucus/blood in feces,
liver enzy,serum alb, glob(prot)
Cercaria PenetrateSkin thruInfectedwater
Yup
Mindanao,Visayas
Praziquantrel
(smallest) ELISA CNS Formosa
SchistosomaIntercalatum
Like Schistosoma Mansoni in terms of life cycle, pathology and clinical featuresIntermediate host – Biomphalaria snail
SchistosomaMekongi
Lide Schistosoma Japonicum in terms of life cycle, pathology and clinical featuresIntermediate host – Lithoglyphopsis aperta
FasciolaHepatica
Fasciolidae
SheepLiverFluke
“popping operculum”
leaf S, w/ shoulders cephalic cone, spinous, dendritic testes
MetacercariaEncystedOn aquaticvegetation
Unembryo ova in feces,duodenal aspirates
Bile duct of Sheep
Herbivoreanimals
Snails-Lymnea Philippinensis,Lymnea swinhoe (TAI)(sporocyst-redia-cercaria)
Aquaticvegetation
Halzoun – ingestionRaw sheep, goat livers(dyspnea, deafness,asphyxiation, death)fibrotic vs. traumatic/necrotic lesions; obs;False vs true (no eggs)
Ingestion ofInfectedVegetation;InfectedLiver (false)
Cosmo
In sheepRaisingcountries
Bithionol
FasciolaGigantica
Fasciolidae
GiantLiverFluke
Larger thanF. hepatica
no shoulders
MetacercariaEncystedOn aquaticvegetation
Unembryo ova
Giant Animals- CattleBiliary tract (BT)
Snail Aquaticvegetation
Ingestion ofInfectedVegetation
MostProbably
Africa,Asia
Bithionol
ClonorchisSinensis
Opistorchidae
ChineseLiverFluke
branchedtestes;spatulate
MetacercariaEncystedOn FreshWater fish
Embryo ovaIn fecesor BiliaryduodenalaspiratesBDA
Man
BT
OperculateSnails(Alocinma, Parafossarulus,Bithynia)
Fresh water Fish (FWF) :Cyprinidae,Ctenopha-ryngodon
Cholangiocarcinoma ofliver, liver function Impaired but SGPT andSGOT are normal
Ingestion ofUncooked fish
Rare
CHI, JPN,SK, Vietnam
ChloroquineDiphosphate
Praziquantel
OpistorchisFelineus
Opistorchidae
CatLiverFluke
lancet S
reddish-bilecolor
MetacercariaEncystedOn freshWater fish
Embryo ovaIn fecesor BDA
Small Animals-Cats, dogs, etc (BT SI)
Snails - Bithynia Funiculate
FWFCyprinusCarpio (Taiwan)
Periportal fibrosis,Invasion of pancreas, Form bile stones
Ingestion ofInfectivefish
Nope
USSR,poland
Praziquantel
OpistorchisViverrini
Opistorchidae
knob at abopercular end
lobed testes like O. felineus
Metacercaria
Embryo ovaIn fecesOr BDA
Civet cat,Dog, fish-eating
Snails - BithyniaGoniomphalus,Funiculate,laevis
FWFPunteus Orphoides,Hampaladispar
Hyperplastic biliaryEpithelium (Stim byNitrosamines); assos.w/ cholangiocarcinoma
Ingestion ofInfective fish
Nope
ThailandUdorn
Praziquantel
DicrocoeliumDendriticum
Dicrocoellidae
Lancetfluke
deepgolden-brown
2 large testeslancet, flat,transparent,aspiny
Metacercaria
Embryo ova
w/ fully devmiracidium
sheep Snails- Abida, Cochilcopa,Helicella, Zeb
FormicaFusca (ants)
Same as F. hepatica
Portal cirrhosis,Periductal fibrosis
Ingestion ofants
Wala siguro
Praziquantel
PARASITE A.K.A. EGG ADULT INFECTIVE DIAGNOSTIC HOST LOC. INT HOST2ND INTHOST PATHOLOGY MOT PHIL Tx
ParagonimusWestermani
OrientalLung Fluke
operculum atbroad end,thick aboper
branchedtestes side by side;coffee bean; integument w/ spines
MetacercariaIn crustacean
Cercaria w/spines
Unembryoeggs in fecesor sputum
complementfixation
Encapsulated inParenchyma of lung; in fibrotic capsules
Reservoir –Cats & dogs
Snail -Miracidia (M)Cercaria (C)AntemelaniaAsperta;Antemelania Dactylus
Crabs –
SundathelphusaPhilippina
C meta-C
Granulomatous rxn in lungs; rust-colored sputum, w/ Foul fish Odor
MisdiagnosedFor PTB
IngestionOf Infectedcrustaceans
Yes
Asia
Praziquantel
Bithionol
Triclabendazole
FasciolopsisBuski
indistinguishfrom F. hep,F. gigantica
2 dendritic testes in tandem
Metacercaria In water Plants
MC are Sensitive to Dryness
UnmebryoEggs in feces
Duodenum of Man or pigs
Snails –M C
Segmentina,Hippeutis
Aquatic VegetationC meta-CWater caltrop,Water chestnut,Water morningGlory, lotus
Worms causeTraumatic,Obstructiveand toxic effects;ulceration and mucus prod.
IngestionOf InfectedWater Plants
Nope
SEA,CHN,India,indonesia
Praziquantel
HeterophyesHeterophyes H.
M.eggs no aboperprotub; same
hard to distinguish adults;scale-like spines, w/genital sucker, globulartestes
MetacercariaIn fish
Miracidiumpresent inThe egg onceDeposited byadult
Unembryo Eggs in stoolUsing Kato-Katz method
Small Intestines
Reservoir – Fish eatingmammals
Snails :Freshwater,Brackish orMarine
M C
Many fish in the Phil. (30 Species); in muscles at base of the fin
C meta-C
Inflamm, Sloughing offOf layers, xsMucus prod
MisdiagnosedFor acid Peptic ds (APD), consistentw/ PUD
Ingestionof MCEncysted infish
Yes
EGY,Greece, CHN, JPN,KOR, TWN,Phil
Praziquantel
Metagonimusyokogawai
EchinostomaIlocanum
indisting.fromfasciolas
oral sucker with collar ofspines; 2 lobed testes intandem, reddish-grey
Metacercaria
No sporocyststage
Unembryo Eggs in feces
SmallIntestines
Reservoir-rats
Snails:-GyralusConvexlusculus-Hippeutis UmbilicalisM C
Snails:-Pila luzonica“kuhol” and-Vivipara Angularis“suso”C meta-C
Inflamm, Ulceration,Diarrhea,intoxiacation
IngestionOf encystedMC in snails
Of course
N. Luzon,Samar,Leyte,Mindanao
Praziquantel
TaeniaSolium
PorkTapeworm
indistinguishfrom each
rostellum w/ hooks4 suckers; ripe proglottid<13 lateral branches; 3m
CysticercousCellulosae
eggs – causecysticercosis
Ripe or gravidProglottid
formaldehydesoln
Scolex aftertherapy
Small intestinesof man
cysticercosisin muscles
Hogs, wildBoars, sheep,Deer, dogs,Monkeys, rats,cats
eggs cysticercouscellulosae
Inflamm,Eosinophilia,leukopenia
Dev Cisticercosis(ingestion of eggs), larva inbrain, muscle,eye
IngestestionOf inadeq.Cooked Pork
AccidentalIngestion ofeggs
yes
cosmo
Praziquantel
other and fromE. granulosus;hexacanth (6hooklets); radially striated shell
TaeniaSaginata
Longest Tapeworm
Beeftapeworm
no rostellum, hookletsripe >15 branches; 5m;tree-like dicho branching
Cysticercousbovis
Ripe or gravidProglottid
Scolex aftertherapy
Man SI(accidental)
Cattle, llama,Giraffe, Carabao
eggs cysticercousbovis
Epigastric Pain, vertigo,Nervousness, eosinophilia
IngestionOf cysts in beef
Niclosamide-damage to point of dissolution
EchinococcusGranulosussmallestTapewormIn man
ParasiteOf dog
one long gravid proglottid
Eggs – manHydatid sand
dogs
x-ray to detect hydatid ds;immunologictests
SI of Dog-Cysts Ingested and Release scolices
Sheep, man(accidental,intermediate–in liver andlungs)
Obstruction – Growing cysts;AnaphylacticShock when Cyst ruptures
FOR
IngestionOf eggs in feces
rare SugeryPrev spillage of eggs)
Albendazole
PARASITE A.K.A. EGG ADULT INFECTIVE DIAGNOSTIC HOST LOC. INT HOST2ND INT HOST PATHOLOGY MOT PHIL Tx
DiphyllobothriumLatum
Fish/Broadt-worm
yellow-brownknob likethickening
spatulate, rosette uterus2 bothria = suckinggrooves
PlerocercoidLarva EncytedIn fish
OperculatedEggs;Proglottids
Kato tech
SI in man
ReservoirHost: Dogs, cats,Bears
Paratenic host:Carnivore fish
copepods (Cyclops & Diaptomus)
Coracidia (CO) Procercoid (ProC)
(fish) perch, trout, salmon, pike
ProC PleroC
Anemia (misdiag for pernicioustype Vit B12 def);hyperchromicmegaloblastic;examine for HCl in gastric juice (+ infection)
Ingestion
Rare
Only7 cases
temperatezone
Praziquantel
DipylidiumCaninum
DogT-worm
DoublePoredT-worm
egg packets(8-15 eggs)oncosphere w/6 hooklets
retractile, conical scolex; rose-thorn shape hookletsmature proglottid – with 2 lateral genital pores
CysticercoidLarva inArthropodHost wheningested
GravidProglottidsThat are passed out/ Crawl out,Egg packets,Melon-shapedProglottids in Chains(Not stool becproGlot disintin environment
SI of dog or cat
Ctenocephalides canis (dog flea)
Ctenocephalides felis (cat flea)
Pulex irritans (human flea)
Trichodectes canis (dog louse)
Minimal symptoms
Ingestion
yup Praziquantel
HymenolepsisNana
Dwarft-worm
with filaments
like D. caninum scolex butwith less hooklets; ripesegment
EmbryoEggs in Contam food and Water
Cyticerci -Can completeCycle in singleHost (autoinf)
EmbryoEggs in feces
Proglottids notRecovered becTheydegenerate
SI of man Insects, riceAnd flour beetles
Enteritis due to Necrosis and DesquamationOf intestinalEpithelial cells
Direct/indirectpathways
FOR
AutoInfection
yup Praziquantel
HymenolepsisDiminuta
Rat T-worm
w/o filamentsbile-stained;fan-like
gravid segment;rudimentary, unarmedrostellum
CysticercoidLarvae ininsects
Eggs in stool(more circular,larger, lackbipolar thickening vsH. nana
SI of man Fleas, beetles, cockroaches, mealworms & earwigs
Minimal andNon-specific
IngestionOf Infectedinsects
yes
In rats<8%
Praziquantel
Sparganosis
Mansoni,Erinacei,Ranarum
Spirometra
mistaken for D. latum;pseudosegmentation w/slit-like invagination
PlerocercoidIn toads, frogs, snakes,
paratenichosts - pigs
White larvaeIn lesion
Adult – Intestines ofCat/man
Larvae – any part, eye,subQT, muscles
Cyclops, copepods
Frogs, Snakes,Toads, rats
Painful edemaDue to migratingLarvae
Eosinophilia, Edema anderythema
IngestionOf InfectedinterMhosts
Not sure surgical
- COPYRIGHT © 2005 -- AUDS MARTINEZ –
- USTMED SEC C ’07 -
PARASITE A.K.A. CYST TROPHOZOITE INFECTIVE DIAGNOSTIC HOST LOC.
INT HOS
T
2ND
INTHOST
PATHOLOGY MOT PHIL Tx
EntamoebaHistolytica
Ameba
greenish-yellowquadrinucleate,thick, rodlikechromatoidal bodies CB, central karyosome (K), w/ chromatin dots
active, progressive,directional;pseudopod PSD:finger-shape, hyaline; w/ ingested RBC
Qudri cysts
-TrophozoitesIn liquid stools-Cysts in Formed stools
Culture, serology to detect invasiveAmebiasis (IHAT)
ELISA most Sensitive indicator
Large Intestines(cecal andsigmoido-rectal)
liver inextraintamebiasis
Flasklike Primary ulcer;
Histo changes:Histolysis, Thrombosis,Petechiae, Round Cell Infiltration, Necrosis
Bacilliary vsAmebic dysentery
IngestionOf Infectivecysts
Yes
Most CommonAre Asymptocarriers
Supportive,Chemotherapy
Asympto – Diiodohydroxyquin
Mod severeMetronidazole
Severe – D + MHepatic – M + emetine
Naegleriafowleri
No cyst only Flagellated form
Large, usually Central K
slug-like;PSD: blunt;
Trophozoite
TrophozoitesIn CSF and tissue Flagellate form inCSF
Brain MeningoencephalitisSevere frontalHeadache,Blocked nose, Altered taste and smell
Kernig’s sign; Leukocytosis w/ neuts, prot, glu
EntersThru Nose
PenetrateCribriform Plate
Multiply inbrain
rare
all typesof soil
Amphotericin
Amp + miconazole andrifampicin
Acanthamoeba
large central K; double cell wall
sluggish; PSD: spine-likeNo peripheral chrom
trophozoite
Cysts and TrophsinTissue
Giemsa or PAS ofScrapings orCornial biopsy
CNScornea
Amebic Encephalitis(immunocompromised)
Amebic Keratitis (assoc w/ use of contam contact lenses)
Thru Lower respiTract orThru ulcerated,Broken skin
Rare
All typesOf soil
Propamidine,Miconazole, neomycin
Corneal grafting
Entamoebacoli
yellow-brown; 1-8nuclei, K eccentric; CB : splinter-like
sluggish, rarely prog and dir; PSD: short, blunt; Bacteria/debris Inclusions
Entamoeba Gingivalis
Mod active, progPSD : blunt, hyalin
Endolimax nana
pale green; 1-4 nuc; K irregCB : bacilliform
sluggish prog; PSD:blunt/hyaline; K – L, cent
Iodamoebabutschlii
1 nucyellow green; K surr w/ granules; endosome
slug, prog;PSD : Blunt/Hyaline
Entamoebahartmanii
1-4 nuc;K small/Central;Diffuse glyco mass
non prog;PSD : fingerlike
PARASITE A.K.A. CYST TROPHOZOITE INFECTIVE
DIAGNOSTIC HOST LOC.INT
HOST2ND
INTHOST
PATHOLOGY MOT PHIL Tx
Balantidium Coli
Largest prot parasiteOnly ciliate
bean-shaped nuc
cytostome; cytopyge;
cyst DFS ofTroph andCysts inFeces
Sigmoidoscopy
SICysts Troph
LI (cecal area) troph
Ulcer w/ roundedBase and wide Neck (vs flask shape)
Diarrhea and Dysenter (indisting. from Amebic)
FOR
Ingestion of Contam Food And water
Siguro
UncommonIn Temperate;Assoc w/Pigs in tropics
Tetracycline
Metronidazole
Iodoquinol
GiardiaLamblia
“gaybowelsyn”
young – 2 nuc;mature – 4 nuc;flagella retractedinto axonemes
pyriform/tear-drop; bi-symm; erratic tumbling motion; 8 flag
Quadricysts
DFS Cysts andTrophs
Biopsy,Entero-test,IF and antigendetection
SIDuo, jeju,upper il
AttachesTo int villiVia adhesDisc on ven
Villus flat and cryptHypertrophy;electrolytes, glu, fluid abs, disacchs; diarrhea most common symptom (89%); spont recovery in 6 wks; chronic – steato, diarr altern w/ constip
FOR siguro
OutbreaksAre water-borne
Oral Metronidazole
TinidazoleFurozolidoneQuinacrineparomomycin
Trichomonasvaginalis
No cyst stage
pyriform; jerkymovements; 4 free flag +1 undulating; axos
Troph Trophozoites In urine,Urethral sec,Vaginal sec,Cervical sec,Semen, Prostatic sec
Female –Vaginal epi
Male – Urethra,Epididymis,Prostate g
-Vaginal discharge –Liquid, green to yellow,Irritating-Speculum – StrawberryCervix (diagnostic)-Vaginitis; urethritis
Sexualintercourse
Passed thruBirth canal
Yes
HostpitalityGirls – 24%
Other groups- 3-8%
Oral Metronidazole
Acid douches
Dientamoeba Frgilis
No known cysticstage
rosette-shaped nuclei; no peri chromatin; K w/ 4-6 granules; no flag
Troph Binucleate Trophs in freshStool samples
In lumenOf LI
-Increase excess mucus-Hypermotility of the bowel
-Colicky ab pain; analPruritis; Peripheral eosinophilia
-Mimics IBS (irrit bow syn)
Co-infectionWith E. vermicularis
Siguro
…as long asmay infectionw/ E. vermic-in pre-schoolsin Germany,Israel, Holland
Iodoquinol
Tetracycline
Metronidazole
LeishmaniaTropica
Old WorldCutLeish
w/ ovoid or rounded bodies
promastigote
Pro M in skin tissuebiopsy
LivesIntracellularIn MacrophagesPMS andEndothelial Cells
Pro M A-Mast
Sand flyPheobotomusSpp
A-Mast Pro M in gut of fly
Cutaneous leishmaniasis
Lesions resemblingLepromatous leprosy
Bite ofSandly vector
Wala
Africa, IndiaSouth amercia
AntimonyCompounds
Second lineDrugs:Amp B,Pentamidine(Kala-azar),MetronidazoleNifurtimox
LeishmaniaDonovani
amastigote
1 free flagellaarising from kinetoplast
Bone marrow,Spleen orLymph nodes
Visceral Leishmaniasis orKala-azar
Splenomegaly, presence ofParasites in RE cells;
LeishmaniaBraziliensis
NewWorldCutLeish
amastigote
Serology –For supportivediagnosis
Mucocutaneous orAmerican Leishmaniasis
Tapir noseErosion of pinna of forestworkers
Trichomon Smaller and longer Troph swabbing Oral cavity Droplets, yes
asTenax
than T. vaginalis
-tartar kissing
Chilomastix Mesnili
knob
-like prod, LemonS
spiralforW;3 antflag +1
cysts Cysts in Semi-formedStools;Trophs in Liquid stools
Cecal regionOf LI
FOR Rare
<1%
PARASITE A.K.A. CYST TROPHOZOITE INFECTIVE DIAGNOSTIC HOST LOC.INT
HOST2ND
INTHOST
PATHOLOGY MOT PHIL Tx
TrypanosomaGambiense
WestAfricanSleepngSicknes
Trypomastigote T-mastigote Parasite inBlood tissuesOr CSF
Serology forLarge scaleScreening
ELISA, IF
In blood,Lymph andCSF
Tsetse FlyReservorHost:DomesticAnimals
Local Infiltration from bite area to lymph and CNS
-Chronic inflammationOf lymphatics-Atrophy of dendronsOf ganglion cells-Winterbottom’s sign,Kerandels sign
Bite ofVector
CongenitalTransmissionpossible
NO
West and CentralAfrica
Supportive
PentamidineSuraminMelarsopenolTryparsamideMelarsen
TrypanosomaRhodesiense
EastAfricanSleepngSicknes
Tsetse FlyReservorHost: Gameanimals
NO
Uh..eastAfrica?
TrypanosomaCruzi
Chaga’sDisease
Epimastigote Trypomastigote T-mastigote Blood smear
Serology –CFXenodiagbiopsy
HistiocytesRE cells(adipose,myocardial, RE, Neuroglial)
Reduviids,TriatomidBugsReservoir:Wild mammals
-Engulfed by histocytesand invade adipose tissue-inflamm response w/ fibrotic encapsulation= chagoma; Romana’s sign
-Bite of Vector-feces-transplacental-accidentalingestion-blood trans
No
Income Groups In Suburbanrural
8-aminoquinolones
Primaquine,Nifurtomax(Bayer 2502)
Toxoplasmagondii
(man)bradyzoite, cyst
(cat?
)male and femalegametocytes
pseudocyst and oocyst w/Sporozoites-Oocyst prodBy sexual Cycle in cat;Pseudocysts-asexual
Serology – IgM detectionBy ELISA;IFA for IgGAnd IgM; PCROf Toxo DNA
In SI of Cat (sexualAnd asexualCycle); in Tissues in Asexual cycle
Definitive –CAT
Mouse or Rat
Man, pigs,Sheep,AccidentalIntermediatehosts
Brain lesions; hepatitis;Chorioretinitis; Lymphadenitis
2 types of postnatal ds1) mild lymphatic (lideinfectious Mononucleosis)2) acute fulminating
Ingestion,Transplacenetal
Yes
Cosmo
Many areChronicIll but areasympto
Pyrimethamine(Daraprim),Trisulfapyri-Midines; Preg – spiramycin, Clinamycin;AIDS –Atovaquone
IsosporaBelli
immature cyst
Schizont, gametesInside host
Mature oocystw/ sporozoites
ImmatureCysts in feces-Oocysts/Sprorcysts in dudenum
SI of man
Definitive –MAN
Malabsorption syndrome;Shortened villi, hyper-Trophied crypts, infiltOf lamina propria, w/Eosins, polys, rounded cells
FOR Not sure Pyrimethamine
Sulfadiazide orTrimetroprim
PneumocystisCarinii
cysts
Surgical openLung biopsy;BronchoAlLav;Bronchoscopy;
interstitial pneumonia;fatal pneumonia in infants;hypogammaglobulinemia,leukemia, Hodgkin’s, etc-lungs are gray and airless;
Droplets,Close contact
Yes
cosmo
Bactrim
Methenamine Silver stain
death due to asphyxia
GAMETE SCHIZONT TROPHOZOITEPlasmodiumFalciparum
Mosquito – Gametocytes;Man – Sporozoites
Hypnoxoite –Latent stage,Cause relapse
Sporogany –Mosquito LC;Schizogony –Human LC- exoerythro(merozoites)- erythro(gametocytes)
PeripheralBlood smears-thick -thin
QBC, Para sight F test (dipstick test),IFA
RBC (Man)Vivax – youngMalariae – oldFalciparum –all
Mosquito :1)Stomach –Gamete form,2)Stomach wall – oocystand sporozoiterelease3)salivaryglands - sporo
AnophelesFlavirostrisMinimus
Anopheles-litoralis-balabacensis-mangyanus-maculates
-Tissue anoxia – basic pathophysio change in malaria-4 mechanisms leading to tissue anox:1. anemia-hemolysis 2. changes in blood flow 3. changes in capillaryendothelium 4. histotoxic shock-parasite virulence factors:1. multiplication capacity 2. red cellselectivity 3. cytoadherence and resetting ability 4. potential to induce cytokine release 5. antigenicity6. antimalarial drug resistance
Blackwater fever, liver dys, hypogly,Acidosis, GI dys, placenta dys, pulmoedema, renal failure, coagulo andthrombocyto, coma
Bite of femaleMosquito
Passage ofBlood w/ ErythrocyticParasite by:-blood trans-contam syringe-neonatal-congenital
Yes
MalariaFree areas-manila-aklan-capiz-guimara-siquijor-biliran-iloilo-leyte N-leyte S-N Samar-Camiquin-Cebu-Catand.
Vivax and Ova –Chloroquine +Primaquine
Falci and Mal-Chloroquine
ChloroquineResistant –Falc
PlasmodiumVivax
PlasmodiumMalariae
PlasmodiumOvale